The effects of rituximab on the lipid profile of patients with active systemic lupus erythematosus: results from a nationwide cohort in Spain (LESIMAB)

Fernández‐Nebro, Antonio; Marenco, JL; López‐Longo, Francisco Javier; Galindo, María; Hernández-Cruz, B.; Narváez, Javier; Rúa-Figueroa, Íñigo; Raya-Álvarez, Enriqué; Zea, Antonio; Freire, Mercedes; Sánchez-Atrio, A; García‐Vicuña, Rosario; Pego-Reigosa, José María; Manrique‐Arija, Sara; Nieves-Martín, L.; Carreño, Luis

doi:10.1177/0961203314534909

Cited by 11 publications

(4 citation statements)

References 31 publications

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“…A study by Fernández-Nebro et al . [ 29 ], in systemic lupus erythematosus patients who are resistant to conventional therapy, showed that Rituximab may help improve long-term lipid profile indirectly by lowering the inflammatory activity. Hence, overall results concluded that rituximab caused a higher increase in total serum cholesterol, but may be manageable and more tolerable over the long course of therapy compared to tacrolimus ( P = 0.37, 95% CI: −27.94–10.29).…”

Section: Discussionmentioning

confidence: 99%

Rituximab versus tacrolimus as corticosteroid-sparing therapy for children with steroid-dependent nephrotic syndrome: A systematic review and meta-analysis of randomized and nonrandomized controlled trials

Ang,

Widjanarko,

Ekaputra

2024

Tzu Chi Medical Journal

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Objectives: Prolonged use of corticosteroids induced complicated course in children with steroid-dependent nephrotic syndrome (SDNS), and the use of tacrolimus, a first-line alternative calcineurin inhibitor (CNI) agent was related to some unwanted adverse effects. Rituximab, a second alternative treatment has been proven to reliably reduce the number of relapses within 12 months with minimal adverse effects. Materials and Methods: Our review follows Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. All the databases were derived from MEDLINE, Proquest, EBSCOhost, Wiley, and Google Scholar within the past 11 years. The risk of bias was evaluated using the Revised Cochrane Risk of Bias Tool for Randomized Trials (RoB 2) and Risk of Bias in Non-Randomized Studies of Interventions. Meta-analysis used Review Manager (version 5.4) with a random effect model to obtain a pooled mean difference (MD) and odds ratio with 95% confidence intervals (CIs). Results: Four studies were included based on our eligibility criteria, and only three were included in the quantitative analysis. Three studies had low and one study had a moderate risk of bias. Pooled data results indicated that Rituximab was superior to tacrolimus in reducing the number of patients with 1–2 relapses (MD = 0.44, [95% CI: 0.21–0.91]) and had higher eGFR values (MD = 6.67; [CI − 2.92–10.61]). However, Rituximab showed insignificant superiority compared to tacrolimus in reducing the number of patients with 3 relapses, sustained remission, cumulative steroid use, serum cholesterol, and serum albumin concentrations. Conclusion: Rituximab exhibits more advantages in treating SDNS compared to tacrolimus, although the treatment options are highly individualized. Both regimens must also be weighed against their potential side effects to achieve a better overall health status.

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Section: Discussionmentioning

confidence: 99%

Rituximab versus tacrolimus as corticosteroid-sparing therapy for children with steroid-dependent nephrotic syndrome: A systematic review and meta-analysis of randomized and nonrandomized controlled trials

Ang,

Widjanarko,

Ekaputra

2024

Tzu Chi Medical Journal

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“…SLE is a chronic autoimmune disease associated with dyslipidemia ( 40 ). A previous study reported that prior to treatment with rituximab, 69% of SLE patients had dyslipidemia, among which the major abnormalities were LDL and HDL ( 41 ). Elfving et al.…”

Section: Discussionmentioning

confidence: 99%

Causal relationships between rheumatism and dyslipidemia: A two-sample Mendelian randomization study

Zhang

Cai²,

Liang³

et al. 2022

Front. Endocrinol.

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BackgroundDyslipidemia is often observed in rheumatic diseases, such as ankylosing spondylitis (AS), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE), yet it remains to be detected whether rheumatic diseases have a causal effect on dyslipidemia.MethodsSignificant (P < 5 × 10-8) and independent (r2 < 0.1) single-nucleotide polymorphisms in genome-wide association studies were selected as instrumental variables to conduct Mendelian randomization (MR) analysis. Inverse variance weighted, weighted median, and MR–Egger regression were adopted for the causal inference. Subsequently, sensitivity analysis was conducted to assess the stability and reliability of MR.ResultsThe MR results revealed positive causal relationships of AS with total cholesterol (TC) (β = 0.089, 95% CI = 0.050 to 0.128, P = 6.07 × 10-6), low-density lipoprotein (LDL) (β = 0.087, 95% CI = 0.047 to 0.127, P = 1.91 × 10-5), and high-density lipoprotein (HDL) (β = 0.043, 95% CI = 0.001 to 0.074, P = 0.009). There was no causal effect of RA on TC (β = 0.008, 95% CI = 4.86 × 10-4 to 0.017, P = 0.064), LDL (β = 6.4 × 10-4, 95% CI = -0.008 to 0.007, P = 0.871), or HDL (β = 0.005, 95% CI = -0.003 to 0.013, P = 0.200). Additionally, SLE had negative causal links for TC (β = -0.025, 95% CI = -0.036 to -0.015, P = 4.42 × 10-6), LDL (β = -0.015, 95% CI = -0.025 to -0.005, P = 0.003), and HDL (β = -0.013, 95% CI = -0.021 to -0.004, P = 0.004). The results were stable and reliable.ConclusionThis study suggested positive causal effects of AS on TC, LDL, and HDL and negative causal effects of SLE on these cholesterol levels, which could provide much help for the pathogenesis and treatment of rheumatic disease patients with dyslipidemia.

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“…Finally, peripheral blood was collected from 35 age matched young juvenile systemic lupus erythematosus (JSLE) patients (fulfilling The American College of Rheumatology (ACR) classification criteria for lupus (1997) ( Hochberg, 1997 ) or the Systemic Lupus International Collaborating Clinics (SLICC) criteria (2012) ( Petri et al., 2012 ) and 121 young juvenile idiopathic arthritis (JIA) patients (fulfilling the International League of Associations for Rheumatology criteria ( Petty et al., 2004 )) (puberty Tanner stage 4-5) attending a young adult or adolescent rheumatology clinic at University College London Hospital (UCLH) or Great Ormond Street Hospital (GOSH) respectively ( Table S7 and 8 for demographics and clinical data). Patients on biologic therapy were not included in the cohorts due to their known effects on lipids ( Hoffman et al., 2018 ; Daien et al., 2012 ; Fernandez-Nebro et al., 2014 ). Informed written consent was acquired from all donors under the ethical approval reference: REC11/LO/0330.…”

Section: Methodsmentioning

confidence: 99%

Sex hormones drive changes in lipoprotein metabolism

et al. 2021

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Summary Women have a reduced cardiovascular disease (CVD) risk compared with men, which could be partially driven by sex hormones influencing lipid levels post puberty. The interrelationship between sex hormones and lipids was explored in pre-pubertal children, young post-pubertal cis-men/women, and transgender individuals on cross-sex-hormone treatment (trans-men/women) using serum metabolomics assessing 149 lipids. High-density lipoproteins (HDL, typically atheroprotective) were significantly increased and very-low- and low-density lipoproteins (typically atherogenic) were significantly decreased in post-pubertal cis-women compared with cis-men. These differences were not observed pre-puberty and were induced appropriately by cross-sex-hormone treatment in transgender individuals, supporting that sex hormones regulate lipid metabolism in vivo . Only atheroprotective apolipoprotein (Apo)A1 expressing lipoproteins (HDL) were differentially expressed between all hormonally unique comparisons. Thus, estradiol drives a typically atheroprotective lipid profile through upregulation of HDL/ApoA1, which could contribute to the sexual dimorphism observed in CVD risk post puberty. Together, this could inform sex-specific therapeutic strategies for CVD management.

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The effects of rituximab on the lipid profile of patients with active systemic lupus erythematosus: results from a nationwide cohort in Spain (LESIMAB)

Abstract: Our results suggest that rituximab may improve the long-term lipid profile of patients with SLE refractory to standard treatment, mainly by reducing inflammatory activity.

Cited by 11 publications

References 31 publications

Rituximab versus tacrolimus as corticosteroid-sparing therapy for children with steroid-dependent nephrotic syndrome: A systematic review and meta-analysis of randomized and nonrandomized controlled trials

Rituximab versus tacrolimus as corticosteroid-sparing therapy for children with steroid-dependent nephrotic syndrome: A systematic review and meta-analysis of randomized and nonrandomized controlled trials

Causal relationships between rheumatism and dyslipidemia: A two-sample Mendelian randomization study

Sex hormones drive changes in lipoprotein metabolism

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